Lec 3, pt 1: HA Assessment Techniques
Light palpation cont...
- 1 cm below surface - never use thumb - Feel a mass, doesn't move, no fluid= malignant mass If you feel liquid they will aspirate
Examination of Lungs: Percussion
-Compare the percussion notes on both sides at the same inter costal level -Percussion is done from the apex to the base of the lung -Dullness on percussion -->Consolidation due to pneumonia/fluid in the lungs -Hyper resonance on percussion -->Excess air in Pneumothorax
DEEP PALPATION
-Deep palpation can reveal information about the position of organs and masses, as well as their size, shape, mobility, consistency, and areas of discomfort. -Deep palpation uses the hands to explore the body's internal structures to a depth of 4 to 5 cm or more. This technique is most often used for the abdominal and male and female reproductive assessments.
Percussion can produce five sounds in the body:
-Flatness -Dullness -Resonance -Hyper resonance -Tympany
Percussion sound can be analyzed according to its:
-Intensity -Duration -Pitch (frequency) -Quality -Location
LIGHT PALPATION
-Light palpation is done more frequently than deep palpation and is always performed before deep palpation. -As the name implies, light palpation is superficial, delicate, and gentle. -In light palpation, the finger pads are used to gain information on the patient's skin surface to a depth of approximately 1 centimeter (cm) below the surface. -Light palpation reveals information on skin texture and moisture; overt, large, or superficial masses; and fluid, muscle guarding, and superficial tenderness.
AUSCULTATION
-The act of active listening to body organs to gather information on a patient's clinical status. -Auscultation includes listening to sounds that are voluntarily and involuntarily produced by the body. -A deep inspiration a patient takes with the lung assessment illustrates a voluntary sound, and heart sounds illustrate involuntary sounds.
PERCUSSION
-The technique of striking one object against another to cause vibrations that produce sound. The density of underlying structures produces characteristic sounds. These sounds are diagnostic of normal and abnormal findings. -The presence of air, fluid, and solids can be confirmed, as can organ size, shape, and position. -Any part of the body can be percussed, but only limited information can be obtained in specific areas such as the heart. The thorax and abdomen are the most frequently percussed locations.
Assessment of the abdomen
1. Inspection 2. Auscultation 3 Palpatation 4. Percussion Auscultation is performed prior to percussion and palpation, as the latter two can alter bowel sounds
Physical assessment findings, or objective data, are obtained through the use of four specific diagnostic techniques:
1. Inspection 2. Palpation 3. Percussion 4. Auscultation Assessment techniques are performed in this order when body systems are assessed. *exception is in the assessment of the abdomen
Deep palpation cont...
4-5 cm or more Thorax checks lungs -consolidation-solid Abdomen for pain
Burn victims
Body temp goes down -Victim can die from losing body temp
ASSESSMENT TECHNIQUES
Describe how to maintain standard precautions during the physical assessment. Establish an environment suitable for conducting a physical assessment. Describe how to perform inspection, palpation, percussion, and auscultation, and which areas of the body are assessed with each technique.
INSPECTION
Inspection is an ongoing process that you use throughout the entire physical assessment and patient encounter. Inspection is the use of one's senses of vision and smell to consciously observe the patient. *Odor: poor hygiene based on malodorous smell
Adventitious breath sounds
Term used when an abnormal sound is heard , but you are unable to determine the sound. - Have someone check for the sound after you
Murmurs
Use bell of stethoscope
PALPATION
Your hands are the tools used to perform the palpation process. Different sections of the hands are best used for assessing certain areas of the body.
